Evaluation of Mandibular Bone After Dental Extraction in Rats Treated With Antiresorptive Drugs.

PURPOSE: Zoledronic acid (ZOL) and denosumab (Dmab) are commonly used to treat bone pathologies. Because these drugs suppress bone metabolism, this study sought to compare their effect on bone repair after tooth extraction. MATERIALS AND METHODS: Four-week-old male Wistar rats were randomly assigned to 1 of 3 groups: ZOL 0.125 mg/kg, Dmab 0.25 mg/kg, or saline solution 10 mL/kg (control). After 1 week of treatment, the first left molar was extracted; the rats were euthanized at 28 days. The jaws were removed and photographed for macroscopic analysis of wound healing and then subjected to tomographic and histologic analyses. Immunohistochemistry was carried out against the receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG). RESULTS: No difference in wound healing, presence of inflammatory infiltrate and bone sequestration, or osteocyte expression of RANKL and OPG was found among groups. Tomographic analysis showed that the ZOL group had less alveolar resorption and more complete alveolar repair compared with the other groups. There was a statistically significant difference in the OPG marker in the control (P = .008) and ZOL (P = .05) groups when comparing the extracted and non-extracted sides. CONCLUSION: Systemic use of ZOL can improve alveolar bone healing; however, the potential risk for the development of osteonecrosis should be considered. Higher expression of OPG seems to be associated with the control of osteoclastogenesis during bone repair.

Frequency of micronucleus in oral epithelial cells after exposure to mate-tea in healthy humans.

OBJECTIVES: The aim of this study was to evaluate the possibility of technique simplification for cytology slides in order to evaluate the frequency of micronuclei (FMic) and conduct a experiment looking to know the FMic of oral epithelial cells of healthy volunteers exposed to mate tea (Ilex paraguarariensis). MATERIAL AND METHODS: This is a laboratorial and nonrandomized trial (quasi-experiment), where the nonusers subjects were exposed to mate-tea, consumed in the traditional way, two drinks, two times a day for a single week. Two cytology of exfoliated epithelial cells were obtained before and after the mate tea exposition. RESULTS: The sample was composed by 10 volunteers. The age ranged from 18 to 33 years (Mean 23; SD5.5). The use of mate tea did not showed significant variation in the FMic (Wilcoxon Signed Ranks Test p= .24). CONCLUSIONS: The proposed technique simplification showed to be reliable, without losses when compared to the conventional technique and with the advantage of eliminate toxic substances, becoming simple and practical tool for research in dentistry. The acute exposure to mate tea did not induce an increase of FMic in exfoliated buccal cells of healthy nondrinkers and nonsmokers subjects and may not have genotoxic effect. More human studies are needed before a conclusion can be made on the oral carcinogenic risk of mate tea to humans.

Does smoking increase the incidence of postoperative complications in simple exodontia?

OBJECTIVE: To investigate whether smoking has adverse effects in simple exodontia. METHODS: A single-centre, prospective study of postoperative inflammatory complications in simple exodontia was performed. All procedures were conducted under similar and sterile conditions. Postoperative complications (PCs) in exodontia were classified as alveolar osteitis (AO) or alveolar infection (AI) and their incidences then added. RESULTS: A logistic regression model for PCs revealed tooth sectioning [odds ratio (OR) = 4.3, 95% confidence interval (CI) 1.0-18.8; P = 0.050], smoking (OR = 4.5, 95% CI 1.0-18.9; P = 0.03) and amount of smoking (> 20 cigarettes/day: OR = 12.3, 95% CI 1.0-149.8; P = 0.04) to be associated with the occurrence of PCs. CONCLUSIONS: Tooth sectioning, smoking and degree of smoking are all associated with the development of PCs such as AO and AI after simple exodontia. Dentists must be alert to these factors when performing simple exodontia in smokers in view of the increased risk for PCs.

A single dose of amoxicillin and dexamethasone for prevention of postoperative complications in third molar surgery: a randomized, double-blind, placebo controlled clinical trial.

BACKGROUND: The aim of this study was to assess the efficacy of a single prophylactic dose of amoxicillin and/or dexamethasone in preventing postoperative complications (PC) after a surgical removal of a single mandibular third molar (M3). METHODS: This study is a randomized, placebo controlled clinical trial. Four groups were included: Group 1 (G1) included a prophylactic dose of 2 g of amoxicillin and 8 mg of dexamethasone; Group 2 (G2) included a prophylactic dose of 2 g of amoxicillin and 8 mg of placebo; Group 3 (G3) included a prophylactic dose of 8 mg of dexamethasone and 2 g of placebo and; Group 4 (G4) placebo. RESULTS: Fifty patients were included. It was observed one case of alveolar infection (2%) and two of alveolar osteitis (4%) resulting in three PC (6%). No statistical differences were observed between therapeutic groups for development of PC, trismus, pain and edema. The use of antibiotics showed an absolute risk reduction (ARR) for PC development of 3.52% and the number needed to treat (NNT) was 29. CONCLUSION: Prophylactic antibiotics and corticoid in a single dose regimen did not bring any benefit on M3 surgeries.

Tooth loss, chewing ability and quality of life.

OBJECTIVES: The aim of this study was to observe the tooth loss over age in a sample of Brazilian patients and analyze their ability to chew, relating it to how much is the loss of oral function impact over the quality of life (QoL). MATERIALS AND METHODS: This is a single center, observational study and the data were collected through clinical examination followed of questionnaires to obtain sociodemographic information, the ability to chew (through the index of chewing ability [ICA]) and QoL (through Oral Health Impact Profile, OHIP-14). RESULTS: The sample was composed by 171 random volunteers with mean age of 47 (SD 15.2). Low number of natural teeth was associated with an increase of age (Spearman's rho correlation coefficient-0.7, P < 0.001, 2-tailed) and chew disability (ICA: chew's ability vs. disability) (Mann-Whitney U-Test, P < 0.001). Chew disability showed a negative impact over the QoL (overall OHIP; Mann-Whitney U Test P < 0.001) and in five of seven OHIP domains (Functional Limitation, Physical Pain, Psychological Discomfort, Physical Disability, Psychological Disability). Age over than 40 years, was also associated with chewing disability (Pearson Chi-Square P < 0.001) and poorer QoL (Mann-Whitney U test P = 0.01). CONCLUSION: This study observed that the chewing disability produces a significant and negative impact over oral-health related QoL and both, poor QoL and chewing disability are related with the decrease of the number of natural teeth.

Tratamento conservador de grande odontoma complexo em mandíbula / Conservative treatment of large complex odontoma in mandible

Introdução: Odontomas são os tumores odontogênicos mais comuns e frequentemente diagnosticados na segunda década de vida. Seu crescimento lento, comportamento benigno e assintomático favorecem sua permanência intraóssea por muito tempo até demonstrarem algum sinal clínico ou serem detectados em radiografias de rotina, podendo alcançar grandes dimensões. Relato de caso: O objetivo deste relato é demonstrar um caso clínico de odontoma complexo de grandes dimensões em mandíbula, descoberto pelo aumento de volume na região de ângulo mandibular, assim como o tratamento cirúrgico conservador, associado com a instalação da barra de Erich, bloqueio maxilomandibular por trinta dias e acompanhamento de fratura patológica com redução espontânea. Realizada proservação de seis anos sem sinal de recidiva. Considerações finais: Ressalta-se a importância do conhecimento pelo cirurgião dentista do perfil clínico-epidemiológico desta entidade. Fica evidente que a investigação radiográfica em casos dentes não erupcionados, de atrasos na esfoliação de dentes decíduos ou posição ectópicas de dentes permanentes pode favorecer o diagnóstico precoce. Preconiza-se o tratamento mais conservador possível, pois a recidiva é rara.